NPIMap

Organization Active NPI

Glendora Anesthesia Associates LP

  • Certified Registered Nurse Anesthetist
  • Glendora, CA
National Provider Identifier
1750748331
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
GLENDORA ANESTHESIA ASSOCIATES LP
Practice address
1794 S Barranca Ave
Glendora, CA 91740-5421
Phone
(626) 858-4600
Fax
(615) 234-1720
NPI assigned
Jan 27, 2016
Last updated
Dec 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Phillip Clendenin
Title
President
Phone
(615) 665-1283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

1794 S Barranca Ave
Glendora, CA 91740-5421

Mailing address

1A Burton Hills Blvd Ste 300
Nashville, TN 37215-6153
Phone (615) 240-3820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160406001636 CA Part B Supplier - Clinic/Group Practice 0143528216 Receives reassigned benefits from 43 practitioners
Practice locations: Glendora, CA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1750748331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD STE 300",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156153",
            "telephone_number": "615-240-3820",
            "fax_number": "615-234-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1794 S BARRANCA AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917405421",
            "telephone_number": "626-858-4600",
            "fax_number": "615-234-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDORA ANESTHESIA ASSOCIATES LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-27",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "CLENDENIN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.